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Reduced dissemination of circulating tumor cells with no-touch isolation surgical technique in patients with pancreatic cancer.

Authors
  • Gall, Tamara M H
  • Jacob, Jimmy
  • Frampton, Adam E
  • Krell, Jonathan
  • Kyriakides, Charis
  • Castellano, Leandro
  • Stebbing, Justin
  • Jiao, Long R
Type
Published Article
Journal
JAMA surgery
Publication Date
May 01, 2014
Volume
149
Issue
5
Pages
482–485
Identifiers
PMID: 24599353
Source
Medline
License
Unknown

Abstract

Circulating tumor cells (CTCs) disseminate from the primary tumor and travel through the bloodstream and lymphatic system. The detection of and/or increase in the number of CTCs during a patient’s clinical course may be a harbinger of forthcoming overt metastasis. We aimed to examine the impact of 2 different surgical techniques, standard (ST) pancreaticoduodenectomy (PD) and no-touch isolation (NT) PD, on tumor behavior and outcome in patients with pancreatic cancer by using CTCs as biomarkers. In this pilot study, patients were randomized to either ST-PD (n = 6) or NT-PD (n = 6). Intraoperatively, blood samples were taken from the portal vein for measurement of CTCs before and immediately after removal of the tumor. An increase in CTCs was seen in 5 of 6 patients (83%) with ST-PD but no patients with NT-PD (P = .003). In the ST-PD and NT-PD groups, median overall survival was 13.0 and 16.7 months, respectively (P = .33); there was no difference in disease-free survival (P = .42). The use of NT-PD significantly reduced the number of CTCs in the portal vein with no benefit in survival outcomes compared with ST-PD, although more extensive studies are required.

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